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  1 / 1959 MEDLINE  
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[PMID]:28467577
[Au] Autor:Keles MK; Simsek T; Polat V; Yosma E; Demir A
[Ad] Endereço:Department of Plastic, Reconstructive and Aesthetic Surgery, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara-Turkey. mukeke@gmail.com.
[Ti] Título:Evaluation of forearm arterial repairs: Functional outcomes related to arterial repair.
[So] Source:Ulus Travma Acil Cerrahi Derg;23(2):117-121, 2017 Mar.
[Is] ISSN:1306-696X
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There are few studies of single forearm arterial injury repair that compare long-term results of intact and obliterated forearm arterial repair. Aim of the present study was to compare long-term results of forearm arterial repair using Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and color Doppler ultrasound (CDUS). METHODS: Records of 166 consecutive patients with forearm arterial injury were reviewed, and 30 patients with same injury (ulnar artery, ulnar nerve, and tendon injuries at flexor zone V) were called back for CDUS and QuickDASH scoring. Patients evaluated with CDUS were divided into 2 groups according to results: patent vessels (Group 1) and obliterated vessels (Group 2), and statistical analysis was performed to compare QuickDASH scores of groups. RESULTS: Difference in QuickDASH scores was statistically significant: Group 1 had lower score (24.27) than Group 2 (36.34), indicating better outcome in patients with patent vessels. CONCLUSION: Vascular repair that achieved vessel patency led to better functional outcome with lower QuickDASH score and less cold intolerance.
[Mh] Termos MeSH primário: Traumatismos do Antebraço/cirurgia
Antebraço
Procedimentos Cirúrgicos Reconstrutivos
Artéria Ulnar
Procedimentos Cirúrgicos Vasculares
Lesões do Sistema Vascular/cirurgia
[Mh] Termos MeSH secundário: Antebraço/irrigação sanguínea
Antebraço/cirurgia
Seres Humanos
Resultado do Tratamento
Artéria Ulnar/lesões
Artéria Ulnar/cirurgia
Nervo Ulnar/lesões
Nervo Ulnar/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2016.36080


  2 / 1959 MEDLINE  
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[PMID]:29182132
[Au] Autor:Kailis V; Hariga H; Docquier PL
[Ti] Título:Prevention of re-fractures of both bones of the forearm in children.
[So] Source:Acta Orthop Belg;82(4):872-875, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of this study was to observe if the re-fracture rate after forearm both bones was decreased by protecting the forearm with a preventive brace for 6 months following the fracture and by ceasing all physical activities. METHODS: We performed a retrospective study in 75 consecutive cases of diaphyseal fracture of both bone of forearms, in 52 boys and 23 girls aged from 6 months to 11 years. It concerned a first episode of fracture in 84% of cases and a re-fracture in 17%. RESULTS: Re-fracture rate was 0% in the group where a protective brace was worn while it was 20% in the group without brace. CONCLUSIONS: Both the wearing of a protective brace and absence of sport for 6 months may decrease the re-fracture rate to 0%, if the patient is compliant by wearing it and by ceasing all physical activities.
[Mh] Termos MeSH primário: Braquetes
Fraturas do Rádio/prevenção & controle
Volta ao Esporte
Prevenção Secundária/métodos
Fraturas da Ulna/prevenção & controle
[Mh] Termos MeSH secundário: Moldes Cirúrgicos
Criança
Pré-Escolar
Redução Fechada/métodos
Diáfises/lesões
Diáfises/cirurgia
Feminino
Traumatismos do Antebraço/diagnóstico por imagem
Traumatismos do Antebraço/prevenção & controle
Traumatismos do Antebraço/cirurgia
Seres Humanos
Imobilização/métodos
Lactente
Masculino
Fraturas do Rádio/complicações
Fraturas do Rádio/diagnóstico por imagem
Fraturas do Rádio/cirurgia
Recidiva
Estudos Retrospectivos
Fraturas da Ulna/complicações
Fraturas da Ulna/diagnóstico por imagem
Fraturas da Ulna/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  3 / 1959 MEDLINE  
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[PMID]:29182126
[Au] Autor:Jordan RW; Aquilina A; Westacott DJ; Cooke S
[Ti] Título:A comparison of ketamine sedation and general anaesthesia for manipulation of paediatric forearm fractures.
[So] Source:Acta Orthop Belg;82(4):836-842, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:The purpose of the study was to compare the use of ketamine sedation and general anaesthesia for manipulation of paediatric wrist and forearm fractures. A retrospective analysis was performed of patients under 16 years treated at our centre between October 2014 and October 2015. Exclusion criteria were open fractures and fractures with complete displacement. Outcomes measured were fracture reduction, the quality of the cast, fracture redisplacement, further surgical intervention and use of theatre time. 66 children were manipulated over the study period; 31 received ketamine sedation and 35 general anaesthesia. No statistically significant difference was found in the rate of re-intervention (p=0.48), quality of reduction (p=0.39), quality of cast (p=0.14 and p=0.21), or redisplacement (p=0.87). Those undergoing general anaesthesia used on average 50 minutes of theatre time and one third required an overnight admission. We conclude that ketamine sedation achieves comparable treatment outcomes to general anaesthesia whilst using fewer resources.
[Mh] Termos MeSH primário: Anestesia Geral/métodos
Anestésicos Dissociativos/uso terapêutico
Redução Fechada/métodos
Sedação Consciente/métodos
Traumatismos do Antebraço/cirurgia
Ketamina/uso terapêutico
[Mh] Termos MeSH secundário: Criança
Feminino
Seres Humanos
Masculino
Fraturas do Rádio/cirurgia
Estudos Retrospectivos
Fraturas da Ulna/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  4 / 1959 MEDLINE  
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[PMID]:28819489
[Au] Autor:Andaloussi S; Amine Oukhouya M; Alaoui O; Atarraf K; Chater L; Afifi MA
[Ad] Endereço:Service de Traumato-Orthopédie Pédiatrique, CHU Hassan II, Fès, Maroc.
[Ti] Título:[Elastic stable intramedullary nailing (ESIN) in the treatment of both-bone forearm fractures in the child: about 87 cases].
[Ti] Título:Les complications de l'ECMES dans le traitement des fractures des 2 os de l'avant-bras chez l'enfant (à propos de 87 cas)..
[So] Source:Pan Afr Med J;27:68, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:This study aims to describe the complications of elastic stable intramedullary nailing (ESIN) in the treatment of both-bone forearm diaphyseal fractures in the child. Between January 2009 and December 2013, 87 children with both-bone forearm diaphyseal fractures were treated by elastic stable intramedullary nailing with Métaizeau nails. 76 boys and 11 girls, with an average age of 12 years, were enrolled in the study. Nailing was promptly performed in 50 cases and after secondary displacement during plaster-cast treatment in the other cases. Both bones were nailed in all cases. All patients underwent systematic plaster immobilization for a period of about one month. On average, nails were removed after about 6 months. Functional outcomes were studied over a mean follow-up period of 10 months. Complications were marked by 14 superficial infections (14 cases), osteitis associated with material (2 cases), refracture (3 cases), pseudarthrosis (3 cases), delayed fracture consolidation (2 cases) and proximal radioulnar synostosis (1 case). Although intramedullary nailing ideally is an osteosynthesis technique suitable for the treatment of fractures in children, it is more invasive than orthopaedic treatment.Indications for treatment should remain within well-established limits.
[Mh] Termos MeSH primário: Pinos Ortopédicos
Traumatismos do Antebraço/cirurgia
Fixação Intramedular de Fraturas/métodos
Fraturas Ósseas/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Moldes Cirúrgicos
Criança
Pré-Escolar
Feminino
Seguimentos
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.68.11058


  5 / 1959 MEDLINE  
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[PMID]:28819468
[Au] Autor:Guifo ML; Tochie JN; Oumarou BN; Tapouh JRM; Bang AG; Ndoumbe A; Jemea B; Sosso MA
[Ad] Endereço:Department of Surgery, University Teaching Hospital of Yaoundé, Yaoundé, Cameroon.
[Ti] Título:Paediatric fractures in a sub-saharan tertiary care center: a cohort analysis of demographic characteristics, clinical presentation, therapeutic patterns and outcomes.
[So] Source:Pan Afr Med J;27:46, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Paediatric fractures are often of good prognosis due to auto-correction of insufficient fracture reduction by bone remodeling. In sub-Saharan Africa, traditional healers are renowned for managing fractures and there is a neglect for specialized pediatric fracture care. We aimed to determine the demographic characteristics, clinical presentation, treatment patterns and outcomes of paediatric fractures in a tertiary health care centre in Yaoundé. METHODS: We conducted a prospective cohort study of all consenting consecutive cases of fractures in patients younger than 16 years managed between January 2011 and June 2015 at the University Teaching Hospital, Cameroon. We analysed demographic data, injury characteristics, fracture patterns, treatment details, therapeutic challenges and outcome of treatment at 12 months of follow-up. RESULTS: We enrolled 147 fractures from 145 children with a mean age of 7 years and male-to-female sex ratio of 2.5:1. The main mechanisms of injury were games (53%) and accidental falls (20.7%). Forearm fractures were the most common fractures (38%). The mainstay of management was non-operative in 130 (88.5%) fractures, with 29.3% manipulations under anesthesia and 17 (11.5%) open reductions with internal fixation. The most surgically reduced fractures were supracondylar humeral fractures. Major difficulties were long therapeutic delay, lack of diligent anaesthesia and the lack of fluoroscopy. The outcome of treatment was favorable in 146 (99.3%) paediatric fractures. CONCLUSION: With the growing population of sub-Saharan Africa and the objective of becoming an emergent region, public policies should match the technical realities.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/métodos
Fraturas Ósseas/epidemiologia
Redução Aberta/métodos
[Mh] Termos MeSH secundário: Acidentes por Quedas
Anestesia/métodos
Camarões/epidemiologia
Criança
Estudos de Coortes
Feminino
Seguimentos
Traumatismos do Antebraço/epidemiologia
Traumatismos do Antebraço/terapia
Fraturas Ósseas/terapia
Hospitais Universitários
Seres Humanos
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.46.11485


  6 / 1959 MEDLINE  
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[PMID]:28604072
[Au] Autor:Varga M; Gáti N; Kalóz E; Bíró Z; Szeverényi C; Kardos D; Józsa G
[Ad] Endereço:Baleseti Központ, Gyermektraumatológiai Osztály, Péterfy Sándor Utcai Kórház-Rendelointézet Budapest.
[Ti] Título:[Ultrasonographic diagnosis of distal pediatric forearm fractures].
[Ti] Título:Gyermekkori csuklótáji törések diagnosztikája ultrahanggal..
[So] Source:Orv Hetil;158(24):944-948, 2017 Jun.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Ab] Resumo:INTRODUCTION AND AIM: The aim of our prospective study was to evaluate the effectivity of sonographic diagnosis of pediatric wrist fractures and analyzing the results of two pediatric musculoskeletal centers. METHOD: Between 2011 January and 2015 December 467 children aged 0-15 with closed wrist injuries and open growth plates were sonographically and radiologically evaluated by an orthopaedic surgeon or a resident in trainee. Sonography was performed immediately after physical examination with linear probes of 7-14 Mhz frequency. Results were compared to conventional two plane wrist x-rays. RESULTS: We found 97 sensitivity and 96 specificity of the sonographic evaluation. Fractures with dislocations and more serious clinical consequences were never missed. CONCLUSION: Musculoskeletal ultrasound is a very effective tool in daily routine for diagnosing or excluding pediatric wrist fractures. Orv Hetil. 2017; 158(24): 944-948.
[Mh] Termos MeSH primário: Traumatismos do Antebraço/diagnóstico por imagem
Fraturas do Rádio/diagnóstico por imagem
Ultrassonografia/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Estudos Prospectivos
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1556/650.2017.30763


  7 / 1959 MEDLINE  
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[PMID]:28471962
[Au] Autor:Meng J; Li Y; Yuan X; Lu Y
[Ad] Endereço:aDepartment of Rheumatology and Immunology bDepartment of Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Chaoyang District, Beijing, PR China.
[Ti] Título:Evaluating osteoporotic fracture risk with the Fracture Risk Assessment Tool in Chinese patients with rheumatoid arthritis.
[So] Source:Medicine (Baltimore);96(18):e6677, 2017 May.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aims to evaluate the discriminative and predictive capacity of the Fracture Risk Assessment Tool (FRAX) to determine the 10-year risk of osteoporotic fracture in Chinese rheumatoid arthritis (RA) patients.This study included 168 RA patients and 168 healthy individuals as controls. The Chinese mainland FRAX model was applied to calculate the 10-year risk of osteoporotic fractures, defined as fracture of the spine, forearm, hip, or shoulder.The incidence of osteoporosis was significantly increased in RA patients compared to controls (P < .05). Bone mineral density (BMD), lumbar vertebra T-score, and femoral neck T-score were significantly lower in RA patients compared to controls (P < .05). BMD, disease duration, DAS28, and glucocorticoid use were important risk factors for osteoporotic fractures in Chinese RA patients. Ten-year osteoporotic fracture risk in Chinese RA patients was higher when BMD was incorporated in FRAX.There was a higher incidence of osteoporosis and reduced BMD in RA patients compared to controls. The FRAX model should integrate femoral neck BMD with other risk factors to evaluate osteoporotic fracture risk in RA patients, making it a valuable screening tool.
[Mh] Termos MeSH primário: Artrite Reumatoide/epidemiologia
Fraturas por Osteoporose/diagnóstico
Fraturas por Osteoporose/epidemiologia
Medição de Risco
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Algoritmos
Artrite Reumatoide/complicações
Artrite Reumatoide/diagnóstico
Artrite Reumatoide/metabolismo
Densidade Óssea
China
Feminino
Fêmur/metabolismo
Traumatismos do Antebraço/epidemiologia
Traumatismos do Antebraço/etiologia
Fraturas do Quadril/epidemiologia
Fraturas do Quadril/etiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Fraturas por Osteoporose/complicações
Fraturas por Osteoporose/metabolismo
Estudos Retrospectivos
Fatores de Risco
Fraturas do Ombro/epidemiologia
Fraturas do Ombro/etiologia
Fraturas da Coluna Vertebral/epidemiologia
Fraturas da Coluna Vertebral/etiologia
Fraturas da Coluna Vertebral/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006677


  8 / 1959 MEDLINE  
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[PMID]:28286986
[Au] Autor:Boschitsch EP; Durchschlag E; Dimai HP
[Ad] Endereço:a Ambulatorium Klimax, Menopause and Osteoporosis Clinic , Vienna , Austria.
[Ti] Título:Age-related prevalence of osteoporosis and fragility fractures: real-world data from an Austrian Menopause and Osteoporosis Clinic.
[So] Source:Climacteric;20(2):157-163, 2017 Apr.
[Is] ISSN:1473-0804
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Age and bone mineral density (BMD) are the most relevant determinants for public health authorities to govern the management of osteoporosis. The objectives of this study were to determine the age-related prevalence of osteopenia and osteoporosis according to WHO criteria and fragility fractures in middle-aged and older women. METHODS: Women ≥40 years, who were referred to a menopause and osteoporosis outpatient clinic for BMD measurements, were assessed for patient characteristics, BMD and previous fragility fractures of the hip, the distal forearm and the vertebrae. Only records of their initial consultations were used for data analysis. RESULTS: Between 1990 and 2012, 99,399 women, mean age 56.1 years, were referred to the clinic for BMD testing. Of the total population, 52.5% showed normal, 34.0% osteopenic and 13.5% osteoporotic BMD. Fragility fractures were reported by 6540 patients, with 3070 (47%) non-vertebral fractures, namely 2518 (38.5%) distal forearm and 552 (8.4%) hip fractures; 66.8% of patients with the non-vertebral fractures were <65 years. CONCLUSION: The prevalence of osteoporosis and fragility fractures in middle-aged women, < 65 years, is hitherto under-recognized. Measuring BMD alone is not sufficient to identify patients at risk for fractures. Supplemental screening for clinical risk factors already during perimenopause may be advantageous.
[Mh] Termos MeSH primário: Fraturas Ósseas/epidemiologia
Menopausa
Osteoporose/epidemiologia
Fraturas por Osteoporose/epidemiologia
Encaminhamento e Consulta/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Áustria/epidemiologia
Densidade Óssea
Feminino
Traumatismos do Antebraço/epidemiologia
Fraturas do Quadril/epidemiologia
Seres Humanos
Meia-Idade
Prevalência
Fraturas da Coluna Vertebral/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170322
[Lr] Data última revisão:
170322
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170314
[St] Status:MEDLINE
[do] DOI:10.1080/13697137.2017.1282452


  9 / 1959 MEDLINE  
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[PMID]:27905183
[Au] Autor:Gieroba TJ; Williams N; Antoniou G; Cundy PJ
[Ad] Endereço:Discipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, South Australia, Australia.
[Ti] Título:Mini C-arm: faster, cheaper, safer?
[So] Source:ANZ J Surg;87(4):282-286, 2017 Apr.
[Is] ISSN:1445-2197
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mini C-arm image intensifiers (IIs) are promoted to permit lower radiation dose than traditional IIs with a lower purchase price and without the need for a radiographer, saving time. In real-world usage, radiation dose is not always lower. METHODS: A retrospective review of prospectively collected data for 620 children undergoing forearm fracture reduction in theatre was undertaken. Imaging was performed with the Fluoroscan mini C-arm or a comparison traditional II. Radiation dose and theatre time were recorded. RESULTS: There was no significant difference in radiation dose as measured by dose-area product (0.013 versus 0.014 Gy.cm , P = 0.22). We noted an inverse association between operator experience and radiation dose. The mini C-arm allowed a shorter procedure time (26 versus 30 min, P < 0.001) and theatre time (13 versus 16 min, P < 0.001). Re-displacement rates were similar (1.3 versus 2.2%). The Fluoroscan is AU$120 000 cheaper to purchase and AU$35 283 cheaper to run per year than the comparison II. Consultants had a 14% lower dose-area product (0.012 versus 0.014 Gy.cm , P < 0.001) and 18% shorter screening time (8 versus 9.8 s, P < 0.001) than registrars. CONCLUSION: The Fluoroscan mini C-arm II does not demonstrate a radiation saving during closed reductions of paediatric forearm fractures but allows shorter procedures and theatre time with similar re-displacement rates. The purchase price is lower than a traditional II. We noted that operator experience reduces radiation dose.
[Mh] Termos MeSH primário: Fluoroscopia/instrumentação
Traumatismos do Antebraço/diagnóstico por imagem
Exposição à Radiação/análise
[Mh] Termos MeSH secundário: Austrália
Criança
Feminino
Fluoroscopia/economia
Fluoroscopia/métodos
Traumatismos do Antebraço/cirurgia
Fixação de Fratura/métodos
Fraturas Ósseas/cirurgia
Seres Humanos
Masculino
Pediatria/instrumentação
Pediatria/métodos
Dose de Radiação
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE
[do] DOI:10.1111/ans.13842


  10 / 1959 MEDLINE  
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[PMID]:27882814
[Au] Autor:Audigé L; Slongo T; Lutz N; Blumenthal A; Joeris A
[Ad] Endereço:a AO Clinical Investigation and Documentation , Dübendorf.
[Ti] Título:The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).
[So] Source:Acta Orthop;88(2):133-139, 2017 Apr.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) describes the localization and morphology of fractures, and considers severity in 2 categories: (1) simple, and (2) multifragmentary. We evaluated simple and multifragmentary fractures in a large consecutive cohort of children diagnosed with long bone fractures in Switzerland. Patients and methods - Children and adolescents treated for fractures between 2009 and 2011 at 2 tertiary pediatric surgery hospitals were retrospectively included. Fractures were classified according to the AO PCCF. Severity classes were described according to fracture location, patient age and sex, BMI, and cause of trauma. Results - Of all trauma events, 3% (84 of 2,730) were diagnosed with a multifragmentary fracture. This proportion was age-related: 2% of multifragmentary fractures occurred in school-children and 7% occurred in adolescents. In patients diagnosed with a single fracture only, the highest percentage of multifragmentation occurred in the femur (12%, 15 of 123). In fractured paired radius/ulna bones, multifragmentation occurred in 2% (11 of 687); in fractured paired tibia/fibula bones, it occurred in 21% (24 of 115), particularly in schoolchildren (5 of 18) and adolescents (16 of 40). In a multivariable regression model, age, cause of injury, and bone were found to be relevant prognostic factors of multifragmentation (odds ratio (OR) > 2). Interpretation - Overall, multifragmentation in long bone fractures in children was rare and was mostly observed in adolescents. The femur was mostly affected in single fractures and the lower leg was mostly affected in paired-bone fractures. The clinical relevance of multifragmentation regarding growth and long-term functional recovery remains to be determined.
[Mh] Termos MeSH primário: Fraturas do Fêmur/epidemiologia
Traumatismos do Antebraço/epidemiologia
Fraturas Cominutivas/epidemiologia
Fraturas do Úmero/epidemiologia
Fraturas da Tíbia/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Fatores Etários
Criança
Pré-Escolar
Feminino
Fraturas do Fêmur/classificação
Fraturas do Fêmur/diagnóstico por imagem
Fíbula/diagnóstico por imagem
Fíbula/lesões
Traumatismos do Antebraço/classificação
Traumatismos do Antebraço/diagnóstico por imagem
Fraturas Cominutivas/classificação
Fraturas Cominutivas/diagnóstico por imagem
Seres Humanos
Fraturas do Úmero/classificação
Fraturas do Úmero/diagnóstico por imagem
Lactente
Recém-Nascido
Modelos Logísticos
Masculino
Análise Multivariada
Razão de Chances
Prognóstico
Radiografia
Fraturas do Rádio/classificação
Fraturas do Rádio/diagnóstico por imagem
Fraturas do Rádio/epidemiologia
Estudos Retrospectivos
Suíça/epidemiologia
Fraturas da Tíbia/classificação
Fraturas da Tíbia/diagnóstico por imagem
Fraturas da Ulna/classificação
Fraturas da Ulna/diagnóstico por imagem
Fraturas da Ulna/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161125
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2016.1258534



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